Cross-sectional study of drivers of animal-source food consumption in low-income urban areas of Nairobi, Kenya

Background Malnutrition, including undernutrition and micronutrient deficiencies is a chronic problem in most developing countries. Animal-source foods (ASFs) provide essential sources of proteins and micronutrients, yet little is known about ASF consumption patterns or household preferences towards animal-source products among low-income populations. This is particularly critical for malnourished children for whom even small increases in consumption could help improve nutrition and health outcomes. This study analysed both the demand as well as the drivers and barriers for ASF consumption among households in two low-income areas in Nairobi, Kenya. Methods Data on ASF expenditures and quantities purchased in the previous week, and reasons for consuming or not consuming ASFs were collected in a cross-sectional study from 205 randomly selected households in Korogocho and Dagoretti settlements. Self-reported reasons for consuming or not-consuming ASFs were described. Demand for ASFs was estimated using the Almost Ideal Demand System to provide measures of demand elasticity for changes in food prices and expenditures. Results On average households purchased 48 grams of ASFs, including fresh milk, per week per household member. Expenditure on ASFs counted for 38% (520 Kenyan Schillings) of the overall food expenditure of which, on average, 48% was spent on fresh milk. Price was the most commonly self-reported barrier for consumption, while taste was reported as the main driver for consumption. The perceived nutritional value was an important driver for consuming more commonly purchased ASFs (beef, eggs, fish and milk). For less commonly purchased ASFs (pork, sausages, sheep and goat meat, offal) taste, access and tradition were given as main reasons for not consuming. Estimated demand elasticities indicated that increases in total food expenditure would lead to greatest increase in the demand for beef meat. Price reductions would increase the demand relatively more for fish, other meats and dairy. Conclusions For most ASFs better affordability would be a clear driver to increase the consumption. However, to increase the variety and quantity of ASFs eaten, other policies targeting improvements in physical access, food safety and consumer education on nutritional values and cooking methods should be considered

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: a WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis

Background Malaria in pregnancy, including asymptomatic infection, has a detrimental impact on foetal development. Individual patient data (IPD) meta-analysis was conducted to compare the association between antimalarial treatments and adverse pregnancy outcomes, including placental malaria, accompanied with the gestational age at diagnosis of uncomplicated falciparum malaria infection. Methods A systematic review and one-stage IPD meta-analysis of studies assessing the efficacy of artemisinin-based and quinine-based treatments for patent microscopic uncomplicated falciparum malaria infection (hereinafter uncomplicated falciparum malaria) in pregnancy was conducted. The risks of stillbirth (pregnancy loss at ≥ 28.0 weeks of gestation), moderate to late preterm birth (PTB, live birth between 32.0 and < 37.0 weeks), small for gestational age (SGA, birthweight of < 10th percentile), and placental malaria (defined as deposition of malaria pigment in the placenta with or without parasites) after different treatments of uncomplicated falciparum malaria were assessed by mixed-effects logistic regression, using artemether-lumefantrine, the most used antimalarial, as the reference standard. Registration PROSPERO: CRD42018104013. Results Of the 22 eligible studies (n = 5015), IPD from16 studies were shared, representing 95.0% (n = 4765) of the women enrolled in literature. Malaria treatment in this pooled analysis mostly occurred in the second (68.4%, 3064/4501) or third trimester (31.6%, 1421/4501), with gestational age confirmed by ultrasound in 91.5% (4120/4503). Quinine (n = 184) and five commonly used artemisinin-based combination therapies (ACTs) were included: artemether-lumefantrine (n = 1087), artesunate-amodiaquine (n = 775), artesunate-mefloquine (n = 965), and dihydroartemisinin-piperaquine (n = 837). The overall pooled proportion of stillbirth was 1.1% (84/4361), PTB 10.0% (619/4131), SGA 32.3% (1007/3707), and placental malaria 80.1% (2543/3035), and there were no significant differences of considered outcomes by ACT. Higher parasitaemia before treatment was associated with a higher risk of SGA (adjusted odds ratio [aOR] 1.14 per 10-fold increase, 95% confidence interval [CI] 1.03 to 1.26, p = 0.009) and deposition of malaria pigment in the placenta (aOR 1.67 per 10-fold increase, 95% CI 1.42 to 1.96, p < 0.001). Conclusions The risks of stillbirth, PTB, SGA, and placental malaria were not different between the commonly used ACTs. The risk of SGA was high among pregnant women infected with falciparum malaria despite treatment with highly effective drugs. Reduction of malaria-associated adverse birth outcomes requires effective prevention in pregnant women